Valvular Regurgitation And Rhythm Have Not An Impact On Mitral Valve Area: An Echocardiographic Study

Abstract

The assesment of severity of stenosis can be obtained by measuring mitral valve area (MVA) and transmitral pressure gradient. MVA can be mesured echocardiographically either pressure half-time (PHT) or planimetric methods. However, PHT may be inaccurate in some clinical settings such as aortic regurgitation (AR), mitral regurgitation (MR), poor left ventricular compliance, atrial fibrillation (AF) and immediately after mitral valvuloplasty. The effects of AR, MR and rhythm on PHT method are controversial. The aim of this study is to assess the correlation between planimetric and PHT methods in determining MVA and to investigate the effects of AR, MR , rhythm on MVA measured by PHT. Two hundred and one patients (31 male, 170 female) 16 to 72 years of age (mean age 40.9 ± 11.4 ) with MS were included in the study. A complete M-mode, two-dimensional and Doppler echocardiographic examinations were performed. Mitral valve area as measured by planimery was 1.74±0.47 cm (range 0.79-2.96), and from PHT was 1.66±0.49 cm (0.5-2.75). MVA obtained by PHT were significantly less than those obtained by planimetry (p<0.001). There was a good correlation (r=0.92, p<0.001) between planimetry and PHT method in pure MS and also in MS with AR, MS with MR and MS with AF ( r=0.92 , r=0.91, r=0.92, respectively)Either PHT and planimetric methods may reliably be used in determining MVA because of the good correlation between them regardless of rhythm and associated valve lesions as AR and MR. However, using both methods together may help to derive more correct information and less mistakes.